NOTE:This form is not an official college application.
This form will be used by the Art, Music, and Theatre Department personnel to set up auditions and portfolio reviews.
Items marked with and asterisk* are required.

Yes! I am a High School senior, a High School graduate, or a transfer student and plan on attending the Bethany College Art, Music, Theatre Awards Day, Feb. 11, 2012.

Fill out the general area below, then the area you wish to be considered for a performance award. You may choose to be involved in more than one area. We will work around your schedule for the day.

I would like to audition or bring my portfolio for a performance award, but need an alternate date!
Contact me.

*Last Name *First Name Middle I.   Gender (M//F)
*Street Address   *City   *State    *Zip
Country      *Home Phone #
*Your E-mail Address  OR 
Your Parent's E-mail Address
*Date of Grad (mo/yr)
*High School or Transfer School Name

High School Address (including street, city, state, zip code)
High School Phone #
*Number of persons coming with you (including you) to the Art, Music, Theatre Awards Day

Yes! I wish to audition for a performance award in Music at Bethany.
Band - Which Instrument?
Choir - Which Voice Range?
String - Which Instrument?
Keyboard?    Piano  and/or    Organ

Will you need for Bethany to provide an accompanist? Yes        No
Instructor's Name
Instructor's Phone #